The widespread use of alcohol, painkillers and other drugs in the military is “a public health crisis,” according to a new report that calls for sweeping changes in the Pentagon’s “outdated approaches” to substance abuse.
According to the Institute of Medicine report, about 20 percent of active duty personnel engaged in heavy drinking in 2008, the latest year for which data was available. Nearly half (47%) had at least one episode of binge drinking.
About 11 percent of active duty personnel reported misusing prescription drugs, compared with just 2 percent in 2002. But it’s the skyrocketing use of prescription painkillers that has many in the military and Congress worried. Military physicians wrote nearly 3.8 million prescriptions for pain medication in 2009, more than quadruple the number of such prescriptions written in 2001.
Without a change in strategy, the report warns that the military’s ability to curb substance abuse disorders among military service members and their families will continue to suffer.
“Alcohol and other drug use in the armed forces remain unacceptably high, constitute a public health crisis, and both are detrimental to force readiness and psychological fitness,” the report says. “The highest levels of military leadership must acknowledge these alarming facts and combat them using an arsenal of public health strategies, including proactively attacking substance use problems before they begin by limiting access to certain medications and alcohol.”
Another major issue noted in the study was the inconsistent attitude toward drinking among the different branches of the military and the fact that alcohol has long been part of military culture. To address that problem, they reports suggests that the military strictly enforce regulations on underage drinking, reduce the number of outlets that sell alcohol on bases, and limit their hours of operation.
The study also noted that the armed forces’ substance abuse programs have not effectively addressed prescription drug abuse, and that the rate of medication misuse is rising. While the increase can be partially attributed to the rise in combat related injuries and stress from multiple deployments, the committee suggests that military health care professionals at all levels need training in recognizing patterns of substance abuse, and need guidelines for referring patients to specialists such as pain management experts and mental health providers.
Changes in health insurance benefits offered to members of the military were also encouraged, including the long-term use of some medications, and treatment delivered in specialized rehabilitation facilities that are not currently covered.
Insurance benefits should also include treatment in office-based outpatient settings, which enable the ongoing monitoring of patients struggling to avoid relapses.
By offering a more effective team care approach, the study concludes that the military would help alleviate the health care provider shortage created by its reliance on substance abuse clinics and allow for easier access and better management of substance use disorders.
That, in turn, could improve detection and care for related conditions, such as post-traumatic stress disorder, depression, and suicidal thoughts. substance misuse and abuse frequently occur along with these conditions, the committee noted.